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Monday Nov 27, 2017

Crafting a Life That's Right for Me, My Family and Patients

November is a hard month for me. It brings a myriad of emotions that run the gamut from overwhelming loss and deep reflection to thanksgiving and joy.

[Beth Oller, M.D., Mike Oller, M.D., and family]

Here I am with my husband, Mike Oller, M.D., and our children. After the twins were born, we had to make changes in our practice to find balance at home and work.

I am writing this four years to the day that my mother died suddenly of a heart attack. The loss was suffocating, made worse by the fact that I learned of her death when my husband interrupted the mandatory mediation I was attending for a malpractice suit.  

Every day there are things I would like to tell my mom and things I wish I could ask. Watching her become a nana when our oldest daughter was born was a gift to us both. I got to see my child adored through the eyes of my mother, and watch my daughter adore her back. That joy would have been multiplied had she lived long enough to know our twins, too. Instead, there have been moments of extreme happiness tempered somewhat by the ache of her absence.

November also brings Thanksgiving, a holiday I have always loved because it allows focus and reflection on our lives and offers a short reprieve from the day to day. It also serves as a gateway to the holiday season, which I enjoy even more now that I am a parent. This year, this time of reflection has been overwhelmingly positive, but that has not always been the case. Sometimes reflection leads to the conclusion that it is time to make a change -- no matter how scary and unfamiliar.

Deciding that self-care is more important than trying to be everything to everyone is empowering. I learned self-care during what was one of the busiest years of my life. My husband and I own our own practice in rural Kansas, and adding twins to a family that already included a 4-year-old while practicing full-time (including maternity care) made my prior ideas about being busy seem naïve. The past year was filled with changes and challenges to my routine, and routine is something I like a lot. I was excited for the babies to be born and savored the time I spent at home, but I had lost the joy I once had in my practice. I still enjoyed many aspects, but I found myself overly frustrated too often. Negativity had taken over, and I didn't like that I had to fight to bring what still felt like my authentic self to the surface.

I left work to deliver the twins a week earlier than expected, and I was not eager to return and face the same negative atmosphere I had left, especially when coupled with the stress of twin infants and the guilt of leaving them.

I had always thought of self-care as a massage, a bubble bath or a nap. The pictures in my head mimicked the ones you see on Facebook of a glass of wine and a book. I would think of how I was going to spend my time off, how I was going to escape. But if I took time to be alone, I felt bad for not spending it with my daughter or doing something I thought of as productive. I felt like I had such limited time to do things I enjoyed that at times I couldn't even enjoy them. Something had to give.

Change came on two fronts. One was a change at work that I had little to do with. After the twins were born but before I returned to work, both nurses at our practices quit. This was devastating. I couldn't see a way that this was not going to make returning to work worse. What I found, however, was that change can bring unexpected positivity. We were, in essence, starting from scratch, so we broke down the structure we had for nursing duties and rebuilt it in a more innovative way. The two staff we hired to fill those positions have helped rekindle my joy in practice. Instead of fueling my mood on days when negativity and cynicism threaten to overtake me and make me feel I have nothing left to give, they pull me back with their willingness to go above and beyond for our patients with an attitude of service. They have helped me to again see the privilege it is to care for patients.

The other change at work was my schedule. I questioned whether I was working enough -- enough days of the week, enough hours, covering enough call. But enough for whom?

I realized I didn't need to keep up with anyone, I didn't need to prove my worthiness as a physician to anyone. My practice and life didn't need to look like anyone else's. I had a responsibility to myself, my family and my patients to craft a life that was right for me so I could be the best for myself and for them.

My husband, the most supportive partner in practice and life I could ever ask for, saw my despair when I was faced with returning to practice as I had done it before. We sat down and crafted a schedule that would allow me to give the time I needed to our family and to my work. This involved cutting back the time I was in clinic, and him taking the overnight call I would have taken prior. My busy OB practice means I am gone from home variable nights as it is, and putting scheduled overnight call on top of that meant that for me to feel balance I would need to cut back on my maternity patients (a part of my practice that brings me much joy).  

The other change came from hours of self-reflection, facing uncomfortable and hard questions on what I wanted and expected from life and from myself. It was only this introspection that allowed me to make the changes to my schedule that I had to make. I knew I would hear ribbing, as good natured as it might be, about not taking call. I knew I would be reminded that I was working "part-time" (even though I still put in long hours during weeks with deliveries).

Most of all I knew I would have to continue to remind myself to tone down the internal pressure. What I have found is a profound peace and satisfaction with my life. I like going to work, interacting with staff and patients, the challenges it provides and the changes I help others make in their lives. I love the time I have at home with my family, and don't feel like time with my children is such a limited commodity that I have to worry about soaking up every moment. I can just be present.

What I realized was something I feel I should have realized long ago but hadn't. If I worked to make a life that I didn't feel the need to escape, then these planned periods of self-care wouldn't be as necessary. If I could work to restructure my life into something that was sustainable instead of draining, then intricate plans for how to spend the hours away from work wouldn't be necessary. I have tried to craft my life into something that I don't need a reprieve from, but something that I enjoy living.

This year it is easier than it has ever been to feel thankful and blessed. I know that not everyone can restructure things as I did, but if you recognize yourself in some of the descriptors above, maybe you can find somewhere to start making changes.

I hope you will find, like I did, that attending to your own needs begins to solve a lot of the problems that seemed insurmountable before. Let's be good to ourselves, and recognize that sometimes what we can give will be more, sometimes it will be less, but it's always enough.

Beth Oller, M.D., practices full-scope family medicine in Stockton, Kan.

Posted at 04:07PM Nov 27, 2017 by Beth Oller, M.D.

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